How To Use CPT Code 26568

CPT 26568 describes a surgical procedure known as osteoplasty, which involves lengthening a metacarpal or phalanx bone. This article will provide an overview of CPT code 26568, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26568?

CPT 26568 is used to describe a surgical procedure called osteoplasty, specifically for lengthening a metacarpal or phalanx bone. This procedure is typically performed using a technique known as osteodistraction, where the provider gradually moves the two segments of the bone apart to create a gap that will be filled with new bone.

2. Official Description

The official description of CPT code 26568 is: ‘Osteoplasty, lengthening, metacarpal or phalanx.’

3. Procedure

1. To perform this procedure, the provider begins by making an incision in the skin over the metacarpal or phalanx bone that needs to be lengthened.
2. They then carefully dissect through the subcutaneous tissue and incise the periosteum, which is the outer covering of the bone, parallel to the skin incision.
3. The provider proceeds to cut the bone into proximal and distal segments, and may use plates and screws to maintain the position of the bones.
4. Afterwards, they repair the periosteum and soft tissue, and close the incision by suturing the skin.
5. In some cases, the provider may apply gradual traction across the finger using external fixation to further lengthen the metacarpal or phalanx bone.
6. After a period of 2-3 months, new bone develops in the gap created, and the external fixator device can be removed.

4. Qualifying circumstances

CPT 26568 is typically performed on patients with congenital shortening of a metacarpal bone in the hand or a phalanx bone in the finger. The procedure is carried out by a qualified provider who is experienced in performing osteoplasty and osteodistraction techniques.

5. When to use CPT code 26568

CPT code 26568 should be used when a provider performs osteoplasty to lengthen a metacarpal or phalanx bone. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 26568, the provider must document the following information:

• Patient’s diagnosis and the need for osteoplasty
• Details of the procedure, including the specific bone being lengthened
• Incision site and length
• Use of any plates, screws, or external fixation devices
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 26568, it is important to ensure that the procedure performed aligns with the code description. Providers should also follow any specific billing guidelines provided by their payer. It is important to note that CPT 26568 should not be reported with other codes that describe similar procedures or services.

8. Historical information

CPT code 26568 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with congenital shortening of a metacarpal bone undergoes osteoplasty to lengthen the bone.
2. A provider performs osteoplasty to lengthen a phalanx bone in a patient with a finger deformity.
3. An individual with a congenital hand condition undergoes osteoplasty to lengthen multiple metacarpal bones.
4. A patient with a finger length discrepancy undergoes osteoplasty to achieve symmetry.
5. A provider performs osteoplasty to lengthen a metacarpal bone in a patient with a hand injury.
6. An individual with a finger length discrepancy undergoes osteoplasty to improve hand function.
7. A patient with a congenital hand deformity undergoes osteoplasty to improve hand appearance and function.
8. A provider performs osteoplasty to lengthen a phalanx bone in a patient with a finger contracture.
9. An individual with a finger length discrepancy undergoes osteoplasty to improve grip strength.
10. A patient with a congenital hand condition undergoes osteoplasty to improve hand dexterity and function.